胰岛素抵抗与尿毒症患者心血管疾病的相关性分析

Correlation analysis between insulin resistance and cardiovascular disease in patients with uremia

目的研究胰岛素抵抗与尿毒症患者心血管疾病的关系。方法选取我院2014年8月~2016年8月接收的60例尿毒症患者作为尿毒症组,选取同期的45例健康体检者作为对照组。比较两组的胰岛素抵抗指数(HOMAIR)以及肾功能指标、心脏功能指标、炎症因子及氧化应激指标水平,分析HOMA-IR与各指标的相关性。结果尿毒症组的HOMA-IR低于对照组,差异有统计学意义(P<0.05)。HOMA-IR与LVEF、S成正相关(r=0.507、0.618,P<0.05),与LVESD、TC、TG、LDL-C成负相关(r=-0.386、-0.458、-0.797、-0.683,P<0.05)。尿毒症组的炎症因子及氧化应激指标水平高于对照组,差异有统计学意义(P<0.05)。HOMA-IR与MDA、T-AOC、SOD、AOPP、hs-CRP、IL-6、IL-8、TNF-α水平成负相关(r=-0.783、-0.317、-0.896、-0.453、-0.367、-0.474、-0.526、-0.602,P<0.05)。结论尿毒症患者心血管疾病的发生与胰岛素抵抗存在密切关系,对评估患者病情及预后有一定的临床价值。

Objective To study the relationship between insulin resistance （IR） and cardiovascular disease in patients with uremia.Methods 60 uremic patients in our hospital from August 2014 to August 2016 were selected as the uremia group,and the same period of the same period,45 healthy persons were selected as the control group.The level of HOMA-IR,renal function,cardiac function,inflammatory factors and oxidative stress were compared,and the correlation between HOMA-IR and each index was analyzed.Results The level of HOMA-IR in the uremia group was lower than that in the control group,with significant difference （P〈0.05）.HOMA-IR was positively correlated with LVEF and S （r= 0.507,0.618,P〈0.05）,and was negatively correlated with LVESD,TC,TG,LDL-C （r=-0.386,-0.458,-0.797,-0.683,P〈0.05）. Inflammatory factors and oxidative stress in the uremia group was higher than that in the control group,with significant difference （P〈0.05）.HOMA-IR was negatively correlated with the levels of MDA,T-AOC,SOD,AOPP,hs-CRP,IL-6,IL-8, TNF-α （r=-0.783,-0.317,-0.896,-0.453,-0.367,-0.474,-0.526,-0.602,P〈0.05）.Conclusion There is a close correlation between the occurrence of cardiovascular disease and IR in patients with uremia,and it has a certain clinical value to assess the patient＇s condition and prognosis.